TY - JOUR
T1 - Remote Ecological Momentary Testing of Learning and Memory in Adults with Serious Mental Illness
AU - Parrish, Emma M.
AU - Kamarsu, Snigdha
AU - Harvey, Philip D.
AU - Pinkham, Amy
AU - Depp, Colin A.
AU - Moore, Raeanne C.
N1 - Funding Information:
This work was supported by the National Institute of Mental Health (grant numbers R01 MH112620 to A.P; R21 MH116104 to R.C.M.; and T32 MH019934 to E.M.P).
Publisher Copyright:
© 2020 The Author(s). Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.All rights reserved. For permissions, please email: journals.permissions@oup.com.
PY - 2021/5/1
Y1 - 2021/5/1
N2 - Smartphone-based ecological mobile cognitive tests (EMCTs) can measure cognitive abilities in the real world, complementing traditional neuropsychological assessments. We evaluated the validity of an EMCT of recognition memory designed for use with people with serious mental illness, as well as relevant contextual influences on performance. Participants with schizophrenia (SZ), schizoaffective disorder, and bipolar disorder (BD) completed in-lab assessments of memory (Hopkins Verbal Learning Test, HVLT), other cognitive abilities, functional capacity, and symptoms, followed by 30 days of EMCTs during which they completed our Mobile Variable Difficulty List Memory Test (VLMT) once every other day (3 trials per session). List length on the VLMT altered between 6, 12, and 18 items. On average, participants completed 75.3% of EMCTs. Overall performance on VLMT 12 and 18 items was positively correlated with HVLT (ρ = 0.52, P <. 001). People with BD performed better on the VLMT than people with SZ. Intraindividual variability on the VLMT was more specifically associated with HVLT than nonmemory tests and not associated with symptoms. Performance during experienced distraction, low effort, and out of the home location was reduced yet still correlated with the in-lab HVLT. The VLMT converged with in-lab memory assessment, demonstrating variability within person and by different contexts. Ambulatory cognitive testing on participants' personal mobile devices offers more a cost-effective and "ecologically valid"measurement of real-world cognitive performance.
AB - Smartphone-based ecological mobile cognitive tests (EMCTs) can measure cognitive abilities in the real world, complementing traditional neuropsychological assessments. We evaluated the validity of an EMCT of recognition memory designed for use with people with serious mental illness, as well as relevant contextual influences on performance. Participants with schizophrenia (SZ), schizoaffective disorder, and bipolar disorder (BD) completed in-lab assessments of memory (Hopkins Verbal Learning Test, HVLT), other cognitive abilities, functional capacity, and symptoms, followed by 30 days of EMCTs during which they completed our Mobile Variable Difficulty List Memory Test (VLMT) once every other day (3 trials per session). List length on the VLMT altered between 6, 12, and 18 items. On average, participants completed 75.3% of EMCTs. Overall performance on VLMT 12 and 18 items was positively correlated with HVLT (ρ = 0.52, P <. 001). People with BD performed better on the VLMT than people with SZ. Intraindividual variability on the VLMT was more specifically associated with HVLT than nonmemory tests and not associated with symptoms. Performance during experienced distraction, low effort, and out of the home location was reduced yet still correlated with the in-lab HVLT. The VLMT converged with in-lab memory assessment, demonstrating variability within person and by different contexts. Ambulatory cognitive testing on participants' personal mobile devices offers more a cost-effective and "ecologically valid"measurement of real-world cognitive performance.
KW - bipolar disorder
KW - ecological momentary assessment
KW - memory
KW - remote cognitive testing
KW - schizoaffective disorder
KW - schizophrenia
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U2 - 10.1093/schbul/sbaa172
DO - 10.1093/schbul/sbaa172
M3 - Article
C2 - 33219382
AN - SCOPUS:85105896322
VL - 47
SP - 740
EP - 750
JO - Schizophrenia Bulletin
JF - Schizophrenia Bulletin
SN - 0586-7614
IS - 3
ER -